Inspection on 24/08/06 for Longlands

This inspection was carried out on 24th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Longlands 14/08/07

Longlands 28/10/05

Longlands 16/05/05

Longlands 25/11/04

Longlands 01/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Longlands Balfour Road Blackbird Leys Oxford Oxfordshire OX4 6AJ Lead Inspector Delia Styles Unannounced Inspection 10:40 24 August 2006 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longlands Address Balfour Road Blackbird Leys Oxford Oxfordshire OX4 6AJ 01865 779224 01865 774769 manager.longlands@osjctoxon.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Orders Of St John Care Trust Mrs Sharon Fenn Care Home 47 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (47), of places Physical disability over 65 years of age (20) Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 47. 28th October 2005 Date of last inspection Brief Description of the Service: Longlands is a care home providing personal care and accommodation for 47 older people. It is located on the outskirts of the city of Oxford in the centre of a housing estate and close to many amenities; the care home is provided by The Orders of St John Care Trust. The home is a two-storey building with a lift, providing single rooms and shared bathroom facilities. There is a large dining room with a bar and seating area at one end, and four other sitting rooms. There is a pleasant courtyard garden that is safe and accessible to residents. The current range of fees is from £484 to £600 per week. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of the service was an unannounced ‘Key Inspection’. During a key inspection, the inspector assesses those National Minimum Standards for a service – in this case Care Homes for Older People – considered most important by the Commission that should be assessed at least once a year. On the first day the inspector arrived at the service at 10.40 am and was in the service for 6 hours. The inspector completed the inspection on the morning of 25 August 2006 and was in the home for a further 2 hours. Feedback was given to the manager at the conclusion of the inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection, or who responded to questionnaires that the Commission had sent out. A total of 4 comment cards (‘Have your say about Longlands) was received from residents; 5 from health and social care professionals who visit the home; 7 from GPs; and 8 from relatives/visitors. The inspector would like to thank all the residents and staff for their assistance during the inspection. What the service does well: What has improved since the last inspection? The care team continue to work well together under the leadership of the new manager who transferred in May 2006 from another local care home run by the Orders of St John Care Trust. There are plans for the redecoration and refurbishment of parts of the home, especially the dining room and lounge on Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 6 the ground floor, that will be undertaken soon and that will improve these facilities for residents’ use. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. 6 is not applicable – the home does not provide intermediate care. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People and their representatives using this service mostly have sufficient information about the home to allow them to make an informed decision about whether the service is right for them. More attention is needed to ensure that the written personalised needs assessment is detailed enough to make sure that staff can identify and plan for, prospective residents care before they move into the home. EVIDENCE: The small sample of residents’ comment cards showed that 75 of the people were satisfied with the information they received about the home before they were admitted. There were copies of the updated Statement of Purpose, brochures and Service User Guides available in the entrance hall to the home. All 8 relatives/visitors comment cards showed that people were not aware of CSCI inspection reports for the home, and did not know how to access the most recent report. A copy of the most recent report was hanging up in the reception area of the home. The manager said that she would remind residents and their families and visitors about how to obtain all the written Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 9 information about the home at the next residents/relatives meeting. All new residents and their representatives are given a pack containing all the relevant details about the home on admission. The Commission should be provided with a copy of the current Statement of Purpose and Service User Guide for the home. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although improving, there is scope for further development of the written records of care to be sure that care staff have sufficient information to plan and deliver the personal care needed by residents and to assess whether their health, personal and social care needs have been effectively met. In particular, risk assessments should be written and reviewed, where residents’ individual physical or mental frailty makes them vulnerable to harm. EVIDENCE: The inspector looked at a sample of three residents’ care records. One person was a new admission who had come in for a respite stay. There was a brief assessment of care needs written by a care manager. This resident had not had a pre-admission visit and was admitted on a Friday. The manager acknowledged this was in contravention of the OSJCT’s own policy: residents admitted for respite stays should be admitted mid-week, so that any queries about their medical or personal care needs can be resolved before week-ends when their usual medical and community support staff may not be available. The inspector felt this was a potentially unsafe admission because there was insufficient information about the person’s care needs, and their usual family support systems and the person themselves had short-term memory problems. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 11 The manager said that this person’s admission had been arranged by a care manager whilst she was on holiday and this would not happen again: all staff and care managers would be reminded of the need to adhere to the OSJCT admission policy for respite care in future. Another resident keeps his/her own medication in their room. Staff have concerns about this person’s ability to safely manage their own medication and to adhere to the prescribed times and dosages. They have raised this with the prescribing GP and the resident, but there is no written risk assessment or record of review of the person’s competence or self-declaration in relation to the risk of continuing to self-medicate. The home manager said that she believed that a care leader had updated the resident’s care records, and that OSJCT has a new ‘non-compliance’ document to record such assessments but the information was not found during the inspection. Risk assessment in relation to nutrition for two of the three residents was not evident. One resident is at risk but a nutritional assessment (based on a reliable validated tool, such as the Malnutrition Universal Screening Tool [MUST]) has not been completed. Residents’ health needs should be regularly assessed to identify those at specific risk, and a record maintained of the appropriate action to be taken to support the resident’s own capacity for selfcare, with access to specialist services where necessary. Inspection of the medication storage area and residents’ medication administration record sheets (MAR) showed that overall the system is well managed. There were at least 2 handwritten MAR entries that had been made by a staff member but not checked and signed by a second person. When a resident’s medication is altered it is good practice to write the name of the doctor who gave the new instructions, and to date and sign the entry including a witness when possible. Changes should also be recorded in the person’s care plan. This reduces the risk of making a medication error that is potentially harmful to the resident. Where residents have prescribed skin creams or lotions that are applied by care staff at other times to the regular medicine ‘rounds’, the MAR sheet should be cross-referenced to the residents’ care plan/record, to show that they have had the prescribed treatment. Staff should be competent in, and aware of the specific instructions for the application of prescribed skin creams and lotions. Two of the 7 GPs who completed questionnaires felt that they were not always able to discuss a resident’s health care needs with a senior carer or carer who consistently cared for their patient(s). The manager felt this might be because doctors tend to visit at lunchtimes when senior staff are busy with medication rounds, and less experienced staff accompany the doctor. This should be further discussed with the doctors to see if more suitable visiting times and/or Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 12 availability of senior care staff can be agreed, so that residents’ health care needs can always be accurately communicated and assessed. Two of the 8 relative’s comment cards reflected some concern about the attitude of some staff towards residents: ‘residents are not always treated or spoken to with respect by some carers’; ‘some of them [staff] are very good. Some do not bother. [the resident] says some are rude to her’. However, it should be noted that the comment cards were completed in late May/early June 2006 and may reflect some past poor practice issues that had been identified and dealt with effectively by the previous manager of the home. A resident spoken with at length during the inspection felt that s/he was treated with respect and dignity by staff. Staff were observed to knock on residents’ room doors before entering. The inspector noted in some residents’ rooms that there were stored packs of incontinence pads. Residents’ personal continence aids and equipment should be discreetly stored in cupboards or wardrobes to protect residents’ privacy and dignity. There is little ethnic or cultural diversity amongst the current residents though the staff are from a wide range of nationalities and backgrounds. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The range of activities is temporarily reduced because the home has a vacancy for the post of activities organiser. Meals and mealtimes are leisurely and an enjoyable social occasion for residents. The manager has a good understanding of the social needs of residents and there is a good capacity for the home to improve again in this area. EVIDENCE: The home was without an activities organiser at the time of the inspection, but the manager was confident that a new person would be recruited to the vacant post. The previous worker had established a varied and popular programme of activities and outings for residents and it is hoped will be built on by the next person. Residents’ comment cards and conversation with residents, showed that people appreciate the organised activities and find that they suit their individual needs. The home has its own newsletter – ‘Longlands News’ – that includes news of past and planned events. An activities calendar and display board in the reception area displays photos and information about the activities that have recently been enjoyed by residents. There is an impressive ‘wishes’ notice board on which residents are invited to post their ambitions of things they would like to achieve, such as long distance trips to their hometown or Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 14 relatives, visits to the seaside, flying etc, many of which were signed as successfully fulfilled. The home welcomes all visitors to residents and there were numerous visitors during the time of the inspection. Resident meetings are held regularly that keep residents and their families informed and involved in any issues regarding the home. Most residents have their main lunchtime meal in the large dining room on the ground floor. This was a leisurely and sociable time with residents sitting at tables for up to four. Residents spoken with were not aware of the day’s menu choices, but some recalled that there is a menu displayed outside the dining room. Consideration should be given to providing individual menu cards for the dining tables so that residents know what is on offer and the alternatives available to them. Most were appreciative of the meals and variety that is available. Several were enjoying a small alcoholic drink from the bar with their meal. Staff were completing an OSJCT ‘spot check’ quality questionnaire for the meals on the day of the inspection, asking residents’ their opinions of their meal choice. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents feel safe and listened to. However formal processes need to be further developed so that residents, relatives and visitors are aware of the homes procedures and how they are applied in the event of a concern or complaint. EVIDENCE: There is a complaints procedure that is included in the home’s information literature. Residents’ comment cards showed that this small sample of people knew how to complain. Five of the 8 Relatives/visitors comment card responses showed that people were not aware of the home’s complaints procedure, though 2 of these respondents said that they had had to make a complaint. The inspector recommends that the manager ensure that the all residents and their families and friends are reminded of the home’s complaints procedure, and this could be a topic included in the home’s newsletter. In practice, the manager and senior care staff (shift leaders) are readily available to visitors to answer any day-to-day queries and concerns and this was evident to the inspector during the inspection. Relatives were made welcome and clearly felt comfortable in coming to the manager and staff to exchange information about residents’ care. The Commission has received information concerning 2 complaints made against the service since the last inspection and judges that the provider has Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 16 met the regulations in relation to complaints. The previous home manager stated in the pre-inspection information submitted that there had been 10 complaints in the preceding 12 months, 7 of which were substantiated and 1 partially substantiated. The current manager said that there were no further complaints. The home has guidance and procedures for staff to follow in circumstances where there are any suspicions concerning possible abuse. Staff are all aware of the procedures, have attended training on the protection of vulnerable adults. All new staff receive a booklet that is part of the ‘Oxfordshire Multi-Agency Codes of Practice for the Protection of All Vulnerable Adults from Abuse, Exploitation and Mistreatment’ as part of their induction pack. They are also given the General Social Care Council Code of Conduct. The home has access to an independent advocacy service, provided by Age Concern Oxford, and takes steps to ensure that residents are enabled to take part in the local and national elections if they wish to and are able. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of cleanliness and odour control in some areas of the home is inadequate. The manager is aware of the shortfall in standards of and fixtures and fittings in some of the communal rooms, and is addressing these with planned refurbishment and redecoration. EVIDENCE: The inspector toured the building and visited three residents in their rooms. Individual rooms were satisfactorily clean but in some areas – notably the corridor carpets and some sitting rooms - the carpets and furniture had old food spillage and stains. The manager explained that there was temporary staffing problem due to staff illness and annual leave that had impacted on the cleaning schedules for the home. There was a strong and unpleasant smell of urine in three rooms and the adjacent corridor areas. Staff are aware of the problems and are attempting to resolve them. One visiting professional’s comment card referred to ‘the only Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 18 major complaints from users and carers relate to housekeeping matters. The home smells of urine and should address carpet cleaning’. The home should regularly self-audit the standards of cleanliness and odour control throughout the home, and take prompt action to address any shortfalls. There should always be sufficient numbers of staff to keep the home clean and fresh smelling, so that residents have a pleasant environment to live in. The dining room carpet is badly stained and the décor dingy, but the room is shortly to be refurbished and decorated, with a washable laminate wood effect floor covering in the dining area and new carpet and chairs in the bar/sitting area. Smaller sitting rooms on each of the home’s units have kitchenette areas for the preparation of drinks and breakfast foods for residents. Two of the ‘fridges in the kitchenettes were observed to be old and the door seals were split. The manager said that new ‘fridges are on order to replace these and a ‘fridge in the main kitchen. One resident’s wheelchair was seen to be dirty and dusty and needs more regular cleaning and attention. The inspector found that the liquid soap dispenser was broken and there were no paper hand towels in the staff toilet. Staff should report any faulty or missing equipment and make sure that repairs or replacement are promptly undertaken, especially in relation to hand washing facilities, because of the importance of infection control. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are generally sufficient to meet the needs of residents, although sickness and annual leave caused some shortages requiring agency workers to cover absences. There is an effective and established training scheme in place for all staff so this should result in better outcomes for people using the service. EVIDENCE: The staff rota showed that the home is providing the number of staff agreed with the registering authority at the time of registration of the home in 2001. Four of the 8 relatives/visitors comment cards stated that they did not always feel that there were enough staff on duty but all the respondents were satisfied with the overall care provided (one person wrote that the care was ‘average’). The manager said that they were experiencing some temporary difficulties with staffing because of staff holidays and sickness and were using agency care staff to cover some absences. As noted earlier, the main impact of shortages appeared to be in the standard of cleanliness in the home although comments from the residents, relatives and professional team members indicate that this may be a longer-term problem. There are currently 5 part-time domestic staff providing a total of 90 contracted hours of work a week. The numbers of domestic and housekeeping staff should be reviewed to ensure that there are always enough staff to maintain a good standard of cleanliness in residents’ environment. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 20 The home’s Head of Care is currently seconded to another OSJCT home to support the manager there, so the manager and other senior care staff are covering her work. The staff records for 3 staff members were examined. One person’s file lacked a photo and confirmation of a satisfactory Criminal Records Bureau (CRB) check. There was evidence of a PoVA first check for this person but not their full CRB. This staff member was working under the supervision of other staff and is not providing personal care to residents. The same person had only one reference on file. The manager explained that she had received a verbal reference and that the outstanding written reference had been requested and she would collect it in person. The personal file checklists – where the administrator or person requesting information about prospective new employees signs and dates the list indicating when the information was asked for and received – were not all complete. The home should ensure that the checklists are up to date and the reason for any delay in receiving information is documented, so that the home can demonstrate that it is rigorous in its recruitment checks for all staff and is protecting vulnerable residents by not employing unsuitable people. The manager confirmed that there are 5 care staff who have National Vocational Qualification (NVQ) Level 2 or above. Seven care staff are currently working towards NVQ Level 2, and 3 are undertaking NVQ Level 3. This represents good progress in the home achieving the recommended proportion of 50 of care staff having NVQ Level 2 or above, although the manager said that lack of external NVQ assessors was slowing the process and was frustrating for the care staff who are keen to progress. The OSJCT has an established programme of training and development for all its staff and future training includes a range of topics – adult protection, falls prevention, care of people with dementia, dining room service, marketing, safe handling of medication, first aid, food hygiene and Control of Substances Hazardous to Health (COSHH). Staff spoken with were enthusiastic about the training they had just attended on care of people with dementia and said it will influence their care in future. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management arrangements are meeting the needs of the service and the quality of the service is improving. EVIDENCE: The home manager, Mrs Fenn, has considerable experience in caring for older people, having worked in a community care team and then in a range of care homes. She became assistant manager of Orchard House (another local OSJCT care home) in 1995 and was the registered home manager from 1999 until her transfer to Longlands House in June 2006. She has successfully completed and achieved the NVQ Level 4 in Care qualification and is awaiting her results having completed the NVQ Level 4 Registered Manager (Adults) course. These are the nationally recognised formal qualifications required for all managers of registered services. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 22 OSJCT has a quality assurance strategy and undertakes audits of the standard of care and facilities in the home, using residents’ and relatives’ questionnaires, the manager’s self-assessment and visits by the quality manager to assess the home’s performance. OSJCT provides ‘Customer Service Training’ for managers. There are regular residents’ meetings attended by a senior member of staff. Residents unable to manage their own financial affairs have relatives or the Oxfordshire County Council Money Management scheme that act on their behalf. OSJCT has internal and external audits of accounts and financial systems. An electronic record is kept of all residents’ personal payments – for example additional charges for hairdressing, chiropody or toiletries. The home keeps a small cash float to ensure that residents can always have access to money to make personal purchases and for spending when they go out on trips from the home. The inspector looked at a sample of the supervision and training records for 3 staff. These were up to date and well organised. The inspector found that wheelchair and hoist batteries were being recharged in the kitchenette area of one unit. Batteries should be recharged in a safe area not accessible to residents and visitors or in the vicinity of water, to avoid the risk of accidents. There was evidence that staff have ongoing fire safety training and other mandatory training sessions in health and safety topics. The OSJCT has developed a comprehensive range of policies and procedures that are regularly reviewed and updated. The policies and procedures folder was in the staff office available for reference. Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations Ensure that residents, their families and representatives are aware of how to access the most recent CSCI inspection report for the home. Provide CSCI with a copy of the current Statement of Purpose and Service User Guide for the home. Ensure that all new service users, especially those admitted for short-stay, respite care, are fully assessed prior to their admission. Improve the detail of care plans and evaluation of care so that there is sufficient detail for care staff to follow to provide the appropriate care to meet the residents’ assessed needs, and to give evidence that care has been effective. Use the MUST tool (or similar validated assessment measure) to assess residents’ nutritional status on Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 25 2. 3. OP3 OP7 4. OP9 admission and regularly thereafter, and to evidence that appropriate action has been taken to improve the nutrition of those residents ‘at risk’. Ensure handwritten alterations on MAR sheets accurately reflect the prescriber’s instructions and are countersigned by the doctor if possible, or a second suitably qualified care staff. Maintain a record to show that prescribed creams and lotions have been applied in accordance with the prescriber’s instructions. Risk assessment and regular review should be undertaken and documented for those residents who are able to take responsibility for their own medication. Residents’ continence aids should be discreetly stored in their rooms. Consider ways in which to improve the way residents are informed about the menu choices available to them, so that they are aware of the menus before each meal and can opt for alternatives if they wish. Improve the standard of cleanliness and odour control in the home. Undertake regular audits and ‘spot checks’ of the environment and take prompt action to address any shortfall. Review the staffing numbers available for domestic and housekeeping work, to ensure that there are always sufficient staff to keep residents’ environment clean, tidy and fresh. Personal staff recruitment files should be complete and up to date, with documentary evidence of a consistent and rigorous process for requesting and checking that all the required information is obtained about new employees before they start work in the home. The reason for missing or delayed information should be documented. The homes quality assurance system should be extended to include the views of stakeholders in the community – for example, GPs, podiatrists, community nurses and voluntary organisation staff. Wheelchair and hoist batteries should be recharged in a safe environment not accessible to residents and visitors. 5. 6. OP10 OP15 7. OP26 8. OP27 9. OP29 10. OP33 11. OP38 Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Longlands DS0000013158.V300680.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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